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Notice to Bank to Stop Payment on a Check
NOTICE TO BANK
TO STOP PAYMENT ON CHECK
Date:
TO:
Gentlemen:
You are hereby directed to stop payment upon presentment
of the following check:
Name of Payee:
Date of Check:
Amount:
Check Number:
This stop order shall remain in effect until further
written notice.
_______________________________
Name of Account
_______________________________
Account Number
By:____________________________
This form should be sent again after six months.
Form 121
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